Cardiopulmonary Bypass Without Heparin

Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because...

Full description

Saved in:
Bibliographic Details
Published in:Seminars in cardiothoracic and vascular anesthesia 2016-03, Vol.20 (1), p.40-51
Main Authors: Rehfeldt, Kent H., Barbara, David W.
Format: Article
Language:English
Subjects:
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Cardiopulmonary Bypass - methods
Heparin - adverse effects
Heparin - therapeutic use
Humans
Perioperative Care
Thrombin - antagonists & inhibitors
Thrombocytopenia - chemically induced
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin inhibitor such as bivalirudin. This review describes the use of heparin alternatives for the conduct of CPB with a focus on the direct thrombin inhibitors.
ISSN:1089-2532
1940-5596
DOI:10.1177/1089253215573326